A Hiccup in Procedure
by FemaleChauvinist
Summary: When a visiting ambassador has the hiccups, Kira and Sisko think it's hardly something that warrants calling the doctor…or is it?


**Disclaimer:** While the attempt has been made to be medically accurate, some artistic license has been taken, and statements made by Dr Bashir are not to be regarded as authoritative. Anatomical features of the Ivernian race, while bearing the same names as Earth human features, may not necessarily perform the same function. The specialty of diaphrenologist is a product of the author's imagination, and any resemblance to an actual specialty is unintentional.

The Ivernian, Andolian, and Chrysotalian races and the planet Hameron are products of the author's imagination, and any resemblance to the name of canon Star Trek races/planets is unintentional. Recognizable characters and plotlines are the property of Paramount and Viacom; all original characters and story © 2015 FemaleChauvinist.

 _Do not post without permission. Do not copy/print without including the above disclaimer in its entirety._

 _First or second season_

''And this is Ops," Commander Benjamin Sisko continued his tour of the Deep Space Nine Space station. He and his first officer, Major Kira Nerys, were playing host to Ivernian ambassador Merryn Iolia on her way to the planet Hameron.

Merryn nodded. "It's a fine facility you have here, Commander."

Kira rolled her eyes behind the ambassador's back, and Sisko laughed softly. "No need for flattery, Ambassador; we know it's a bucket of bolts. But we like to think we're making something of it."

"I'm sure you a-re." The last word was broken by a loud hiccup, and Merryn's eyes widened. "P-perhaps a visit to your medical facility should be next in order. You _do_ have an infirmary on this station?" She covered her mouth as another hiccup escaped.

"Of course, and at this point it's one of the best-equipped departments on the station, if not _the_ best. But surely you don't want to bother the doctor about hiccups? The way to cure those is to drink a whole glassful of water while holding your breath."

"We should go down to Quark's," Kira suggested. "A shot of Andolian brandy always works for me."

"Yes," Sisko agreed. "This way, Ambassador; we'll have you fixed up in no time."

Merryn reluctantly followed Sisko, thinking disparagingly of Starfleet medicine. If the infirmary was the best-equipped department on the station and the best they could offer for hiccups was to hold one's breath while drinking, the place was in even sorrier shape than it appeared.

Kira had been walking slightly behind Sisko and the ambassador; suddenly she jumped in front of them. "Cardassians!"

Merryn jumped, catching her breath in surprise, then drew herself up stiffly. "Just wha-ic — do you think you're doing?"

Kira shrugged. "Sorry; that one always worked for me."

As she and Sisko continued to debate hiccup remedies, Merryn wondered a little desperately if they were both crazy.

"Here we are," Sisko announced. "After you, Ambassador."

Merryn glanced around before stepping into the bar, thinking that if she saw any diretionals to the infirmary, she might make a run for it. But one of the things the station lacked was adequate signage, and she resigned herself to whatever quack remedies the commander had devised.

Sisko ushered her to a table, where she slid miserably into the booth across from Kira and Sisko. They were both laughing, and she thought daggers about Federation personnel making light of physical ailments. If this was the care one could be expected to receive, perhaps she would advise the Ivernian council to think twice about joining…assuming she ever made it back.

Merryn looked up without much interest as a Ferengi bartender approached their table. "And what can I get for you today?" At a particularly loud hiccup that caused Merryn to press both hands to her belly that was now aching sharply, a knowing smirk crossed his face. "Ah…a Chrysotalian lemonade…extra sour. The usual for the two of you?"

Sisko and Kira nodded, and the Ferengi hurried off, returning shortly with three drinks on a tray. He took the tall glass of foaming yellow liquid and set it in front of Merryn with a flourish. "There you are; one sip of that and your hiccups will be gone."

Merryn smiled weakly, picking up the glass and pretending to sip. She wasn't averse to trying it, though highly skeptical that it would actually work, but it was taking all her concentration now to breathe between hiccups; she feared she'd choke if she tried to swallow anything.

The Ferengi watched her anxiously, looking incredibly disappointed when the next hiccup struck, as she had known it would.

Sisko chuckled. "You have it bad," he said teasingly.

Merryn found she wanted nothing so much as to lie down, and wondered if he would agree now that a trip to the infirmary was in order. But she wasn't sure she had the breath to make the request, or the energy to get there if she did. Black spots seemed to be dancing in front of her eyes, and she blinked to clear her vision.

"And look who just walked in," Sisko murmured. "You wanted medical advice… Hey, Julian!" he called in a louder tone. "What's a good way to get rid of hiccups?"

The slim young man who had just entered turned toward their table. "Well, I always thought —"

He was interrupted by the sound of a hiccup so severe Merryn feared she might be ill, and whirled around. "You didn't say it was the Ivernian," he hissed. In a single stride he was crouched at Merryn's side, his hand pressed to the pulse in her wrist. "Ma'am, I'm Dr Julian Bashir. How long have you been having these hiccups?"

Merryn looked at him with eyes that pleaded for help. Had Sisko taken her to the infirmary half an hour earlier, she would have had no faith in a doctor so young; would perhaps even have refused to let him treat her; she didn't trust the experience of any physician without gray hair. But now she was desperate enough to accept any aid offered, and the fact that he alone took her seriously raised her opinion of this doctor, young as he might be. His tone, too, had changed in the instant he understood the situation, inspiring trust with its serious professionalism.

She opened her mouth to answer, but found she could only gasp for breath in the wake of another hiccup. Bashir swung his gaze to Sisko, his eyes demanding an answer. "Commander? How long?"

"About half an hour," Sisko said slowly. "But surely, Julian…"

Bashir was paying no attention, his attention completely focused on his patient as he ran his tricorder over her abdomen. "And they've been getting worse."

It was a statement, not a question, but Merryn nodded anyway.

Swiftly putting his tricorder away after checking the results, Bashir tapped his combadge. "Bashir to transporters; two to beam to the infirmary."

Sisko and Kira stared at each other as Bashir and the ambassador disappeared in a sparkle of light. "The doctor's never misused internal transport before," Sisko mused incredulously, "but for _hiccups_?"

 **oOo**

Merryn materialized still in her seated position, but with no booth to support her. With no one there to observe him, Bashir caught her before she could fall to the floor. She let herself relax into the doctor's strong arms as he swiftly stood and turned to lay her in the biobed, the monitors humming to life as he switched it on.

"Stay with me," Bashir murmured, rapidly gathering his instruments. "Don't pass out yet."

Her mind clung to the warmth of his voice even as she struggled to breathe past the hiccups that were now coming almost constantly.

With a single deft stroke of a laser scalpel, Bashir cut open the rich gown she wore. He pressed a hypospray to her exposed abdomen, then ran an instrument over her belly.

The next hiccup seemed to come with less force, then gradually they decreased in frequency. As Bashir straightened with an air of relief, Merryn lay limply, thinking only about being able to breathe freely at last.

"That's better," Bashir said brightly. He laid a hand on her wrist, a gesture of comfort more than a diagnostic one. "You'll be all right now, Ms Iolia."

After the apparent unconcern of the commander and the major, Merryn found her eyes filling with unaccustomed tears at the doctor's gentle comfort.

"Ms Iolia?" he asked softly.

"I…asked to go to the infirmary," she whispered. "But they only laughed at me — I was starting to think they wanted me dead!"

"Easy," Bashir murmured soothingly, running his tricorder over her abdomen. He paused to study the results, then looked up. "You really can't blame them too much," he told her with a lightness he didn't feel. "In both their species, hiccups are usually just a minor inconvenience, and everyone has his own favorite remedy for trying to get rid of them."

"Ah," Merryn murmured, relaxing as she understood. "Then it was simply a misunderstanding…"

"Yes; neither of them realized that for an Ivernian, hiccups are a medical emergency."

"But you're Terran, too…and you knew…"

Bashir grinned. "I'm a xenologist; it's my job to know. And I read up on your species when I found out you were coming…just in case." He pressed a blood analyzer to her wrist for a moment.

"Your oxygen levels don't look bad, but I'm giving you a dose of triox to be safe," he told her, shifting the collar of her robe to inject the medication in her neck.

At that moment, his combadge beeped. "Sisko to Bashir."

"One moment, Commander," Bashir responded. "Jadera," he called, waving over the nurse who stood waiting just outside the room.

"Yes, sir?"

"Help the ambassador into a hospital gown — front access — while I speak with the commander." He turned his back and stepped across the room to grant some measure of privacy before tapping his combadge. "Bashir here," he said tightly.

"I'd like to speak with you in person, Doctor."

Bashir winced at the harsh tone of the commander's voice, but was in no mood to try to placate him. "I can't get away just yet; wait in my office and I'll join you as soon as I'm free." His own voice held a hard edge; he didn't take lightly the risking of life, intentional or not. "Bashir out."

He remained standing where he was until Jadera spoke behind him. "She's decent, sir."

He turned with a forced smile. "Thank you, Nurse."

"She was concerned about the damage to her robe…I told her Garak could either repair or duplicate it."

Bashir nodded. "See that it's taken to him, or call him to pick it up himself." Dismissing her with a gesture, he returned to his patient's side.

"Doctor…you should have gone to speak with your commander."

Bashir smiled tenderly at her. "Sisko can wait; you're my patient, and I'm not leaving you until I'm sure you're not going to have another attack, or suffer any severe effects from the one you did have. Now," he continued, dismissing the matter of the commander, "can you tell me where it hurts?"

 _Where it hurts,_ she realized, not _if_ , and her respect for him rose another notch. He knew she was in at least minor pain, and refused to give her the opportunity to deny it.

"Here," she murmured, laying a hand on her belly.

"Just sore, or is it a sharper pain?"

"Sore."

He nodded in acknowledgement. "Are you nauseated at all?"

"A little…not like before."

"Any chest pain or shortness of breath?"

"No…my throat hurts a little when I swallow."

"Does it feel raw, or as if the muscles are sore?"

"The muscles."

"But it doesn't affect your breathing," Bashir confirmed.

"No."

"I'll check for swelling in a minute; does anything else hurt or feel unusual?"

"My head aches a little, but I think it might help if I could take my hair down."

"May I?" Bashir asked softly, resting a hand on the pinned waves, aware that some cultures considered taking a woman's hair down to be an intimate gesture.

"Please," she murmured, sighing in relief as he gently removed the pins and set them aside.

"I doubt the headache is anything more than stress, but I need to check the abdominal pain…here, you said?"

She nodded.

"All right; let me know if I hit an especially tender spot." He lightly pressed his hand over her whole abdomen, letting his fingers probe deeper in some areas. He smiled to himself as he recalled an article he had recently read about biomedical scanners eliminating the need for physical examination, and mentally shook his head. Call him old-fashioned — and scanning devises certainly had their place — but nothing could ever replace the physician's hand for determining _where it hurts._ It was more personal, too, he felt, making the doctor seem more human and less aloof. For that reason, he would often check pulse or temperature by hand even if his tricorder had already told him all he needed to know.

Then with two fingers pressed at one point, he lightly applied pressure with his thumb at a point he had already tested, and she yelped in pain.

Bashir grinned. "Believe it or not, that's a good sign; you don't have any damage to the phrenic nerve."

He would have to write a letter to the editor regarding that article, he decided. With the simple pressure of his hand, he had dismissed the possibility of nerve damage that would show up only on the most sophisticated of scans, and that with a high margin of error, while a damaged nerve left unrepaired could lead to further attacks of hiccups as well as other serious complications. Any Ivernian doctor who adopted the espoused "touch-free" medicine would find himself performing unnecessary surgeries to repair healthy nerves, while damaged ones went undetected and untreated. And there were numerous examples in other species as well…

Half his mind had wandered for less than a second; for all intents and purposes his attention had been fully on his patient the whole time. Now he reached for the aural monitor and slipped the earpiece in his ear, placing the device on her chest. "Take a slow, deep breath for me, please…hold…and out." He listened for several minutes, instructing her to breathe various ways, until he was satisfied that there were no abnormal involuntary breathing patterns still present.

"Have you ever had hiccups before?" he questioned as he returned the earpiece to its place on the side of the aural monitor.

"No." She laughed softly. "I didn't know what to think, when your commander and that girl were talking as if they'd both had them…"

"Most Terrans and Bajorans have at some point; they're especially common in children, but any age can get them. Can I assume you've had a physical in the past year?"

"About eight months ago…yes."

"And there was nothing of note?"

"No."

"Do you have any known drug allergies?"

"No."

"Any other medical conditions?"

"No."

"No illnesses recently that you've taken medication for, even non-prescription?"

"Depends on how recent you mean."

"Say the last Bajoran month…I think that's roughly two weeks, Ivernian time," Bashir estimated rapidly.

"Then no."

"And you've been feeling fine up until today; not even a little off?"

"Yes."

"No hitches in your breathing or sudden need to take a deep breath?"

"No."

"All right, then; I'm just going to have a look at your throat."

He shined a light down her throat to check for swelling, then lightly rested a hand on the outside of her neck. "Swallow," he ordered.

"Looks good," he said, nodding as he removed his hand. "There's some muscle strain, but no obvious swelling; I'm going to give you a muscle relaxant and anti-inflammatory just to be on the safe side. Let me or one of my staff know immediately if you start feeling as if your throat is closing, or if you have difficulty swallowing." He deftly injected the medication, then moved to wheel over a large piece of equipment. "I want to get a more detailed scan, just to be sure there aren't any underlying conditions or residual damage," he explained. "Just lie still; it's completely painless."

He watched the scan in real time, several times touching the screen to freeze an image for later study.

"All right," he said at last, wheeling the machine away. "I don't see any contributing factors, so it looks like this was an isolated event, brought on by an unknown factor — the cause in these cases is often never determined. I'm going to give you one more treatment, and then something to help you sleep."

He reached for the wand he had used before, running it over her abdomen again.

"Anything else I should be aware of?" Bashir questioned as he readied the hypospray.

Merryn shook her head. "I don't think so."

"Then sweet dreams," Bashir said with a smile, injecting the contents of the vial. He watched the monitors closely as she drifted to sleep, nodding in satisfaction when the readings remained steady. "Jadera?"

"You want me to stay with her, sir?"

"Yes, please; she doesn't really need intensive care, but I'd prefer she not be alone just yet. Are you familiar with Ivernians at all?"

"No, sir."

"Keep an eye on her breathing," Bashir told her. "I'm routing the monitors to my office, so I should notice any major issues, but don't hesitate to call me if her breathing pattern changes or she seems to be in distress."

"Yes, sir. Good luck with the commander."

Bashir gave her a twisted grin. "Maybe you should be wishing the commander good luck with me."

"Sir?"

Bashir shook his head grimly. "Never mind. Carry on, Jadera, and don't hesitate to interrupt if you're concerned for any reason." Turning, he strode toward his office.

On entering, he went straight to the bank of monitor screens and began adjusting the settings to display the ambassador's information, ignoring Sisko who stood with his back turned, arms crossed and posture stiff with anger.

At first he had been merely mildly upset with the doctor's frivolous use of internal transport. He had meant to impress the ambassador, Sisko assumed, and couldn't entirely fault him for that even if he had gone too far. If he wanted to give her the full professional treatment for hiccups, that was one thing, but he had intended to speak with him about misusing his authority and wasting the station's resources on unnecessary internal transport.

Then the doctor had been short with him, almost rude, going so far as to nearly cut him off. On top of that he had claimed he couldn't get away, a mere delaying tactic to avoid a well-deserved scolding, Sisko felt sure. He could have ordered him to report immediately, but had refrained, wanting to see just how long Bashir would keep him waiting.

Now he stood, his anger building, as the doctor fiddled with his computer screens without even acknowledging his superior officer's presence.

At last Bashir turned. "Have a seat, Commander," he offered tightly.

Sisko remained standing, turning on him with hard eyes, and Bashir was wise enough not to sit before the commander did. "I suppose you think you can justify your use of internal transport?" Sisko questioned with a touch of sarcasm.

"In five more minutes she would have been unconscious; in ten she would have been in a coma that I'm not at all sure I could have brought her out of. I suppose _you_ can justify denying a visiting dignitary life-saving medical care?"

Sisko's eyes narrowed. "She had _hiccups_ , Julian; that's hardly a symptom of life-threatening illness."

"In humans or Bajorans, no," Bashir agreed evenly. "Though even there I could give you exceptions. But in Ivernians it's called syncopated diaphrynetic spasms, and let me assure you, it _is_ almost always fatal without treatment." His tone edged on the sarcastic for a moment before softening slightly. "Commander, I don't expect you to know which symptoms are dangerous in every species — that's my job."

Sisko looked hard at him, but saw no sign that he thought he was exaggerating — as of course he must be; even a xenologist couldn't possibly keep track of all the dangerous symptoms in all species.

"That's why you should refer _any_ symptom in a species other than Earth human to me," Bashir continued, giving Sisko the benefit of the doubt regarding knowledge of Terran symptoms. "Especially if the person in question specifically asks for medical attention, as I understand the ambassador did."

Sisko's eyes narrowed. "I don't appreciate being reprimanded by a junior officer, Doctor."

"I _am_ chief medical officer, _Commander_. You may be in command over Lieutenant, junior grade, Julian Bashir, but in questions of health, _Dr_ Bashir is the highest ranking person on this station." He crossed his arms, staring Sisko down; it was the commander who after a tense moment first broke eye contact.

"If you hadn't happened to walk by…" he groaned.

"We would be involved in an interplanetary incident," Bashir finished.

"But why didn't she explain?" Sisko asked, sinking into the chair in front of Bashir's desk.

Bashir followed the captain's lead, sitting behind the desk and keeping one eye on the monitors. "If you were experiencing chest pains on an alien space station and your hosts were offering only folk remedies, would it occur to you that you needed to explain it was likely a symptom of a heart attack?"

"Maybe not, but pain is pretty generally recognized as a sign of something serious."

"Severe pain, yes. But if you had a mild to moderate headache, you might work through the pain for several hours before coming to me, while the same level of chest pain would bring you to the infirmary almost immediately — or at least, I hope it would," he added sternly. "So a species in which chest pain isn't a symptom of heart trouble wouldn't regard mild angina as any worse than mild headache.

"Besides, the likelihood of it happening isn't the point. The point is, it's such common knowledge among humans that chest pain indicates something serious that it wouldn't even occur to you that the aliens might not know that. Similarly, every Ivernian knows that hiccups need immediate professional treatment; it never would have occurred to her that you didn't know. And she _did_ ask to go to the infirmary."

"I know," Sisko murmured. "I just didn't want to bother you for something as silly as hiccups…"

Bashir snorted. "Right…so instead you ask for my unofficial opinion when I'm off duty. We doctors hate that, you know — though in this case I'm glad you did. And seriously, Sisko, you 'bothered' me for a sore throat we both know was from yelling at an admiral. If _you_ had been the one with hiccups as bad as hers were getting, I guarantee you you would have been in here asking me for a cure." He grinned. "And I _can_ cure hiccups in Earth humans, too, you know."

Sisko chuckled. "I've no doubt. Can I see her, Julian? I'd like to apologize."

Bashir shook his head. "She's sleeping now; she won't be up to visitors for a couple of hours."

"Will she be able to attend the reception this evening?"

"No; I'm keeping her here overnight. And anything tomorrow is subject to doctor's approval depending on how she's doing."

"But she _is_ going to be all right?"

"Yes. She actually had a fairly mild attack; if she had received immediate treatment, I'm not sure I would even have had to admit her. She'll need to go on preventative medication to prevent further attacks, but I don't foresee any long-term consequences."

Sisko nodded, getting to his feet. "I'll let you get back to your patient then, Doctor. Give me a call when I can come see her."

"Will do," Bashir agreed, also rising and walking the commander to the door. "No hard feelings?"

Sisko smiled sheepishly. "I should ask you that."

Bashir grinned. "Call it even, then."

 **oOo**

By the next day Bashir had released Merryn from the infirmary; on the day before her scheduled departure she returned for a last checkup and the doctor's final recommendation on continuing her diplomatic mission.

"Physically, I don't have a problem giving you clearance to leave; all your scans have been normal," Bashir said slowly. "My concern is that you're traveling without an Ivernian doctor."

"And how would you know that?" Merryn protested, sure that she hadn't mentioned it one way or the other.

"Um, well, if you had had your own doctor, you would have asked to go back to your ship instead of to the infirmary," Bashir stammered. "Anyway, the point is, even with daily medication and normal scans, those who have had one attack of hiccups are twenty-five percent more likely than the general population to suffer a second attack."

"I know now to tell people that they're serious," Merryn assured him.

"Which is good, but they're not all that likely to have a xenologist; even if they do, it doesn't necessarily mean he's studied Ivernians. I have my reservations about giving you permission to continue to Hameron unless an Ivernian doctor meets you here and travels with you, or you return to Ivernia first and get clearance from a diaphrenologist."

"Ah, I see; you just don't want to be held responsible if anything happens," Merryn realized.

Bashir's expression softened. "I'm truly concerned about your welfare, Ms Iolia," he assured her. "If I received a request for medical control regarding hiccups, my first thought would be your health. But that doesn't mean I can afford _not_ to worry about the legal consequences for me if something were to go wrong after I released you with full permission to resume normal activities. If you insist on continuing on without an Ivernian physician, I'm going to ask that you sign a waiver stating that you're doing it against medical advice and releasing me from any legal responsibility should something happen."

"I understand completely," Merryn assured him. "I can sign the waiver whenever you have it prepared."

"It's right here," Bashir told her, producing a datapadd.

"You knew all along I'd insist on keeping to my schedule," Merryn said with dawning realization.

Bashir gave her a small grin. "I figured ambassadors would be about as stubborn as Starfleet officers in that regard." He waited as she read and signed the waiver, then took the PADD back with a nod of thanks. "Now, I want you to be sure to take your medication as prescribed; do you have any questions about that?"

"No; you were quite clear, and I think the supply you gave me is more than sufficient to last until I get back to Ivernia."

"Erring on the side of caution. I'm also giving you a data solid detailing what happened, the treatment I gave, and the appropriate treatment if it should happen again. I want you to keep it with you at all times, and if you have another attack insist on seeing a doctor immediately and make sure he reads it. It will also have instructions on contacting either me or the Ivernian medical council with any questions. It would probably be an even better idea to visit the attending physician as soon as you arrive and let him go over the information; that way he can be prepared in the event he does have to treat you."

Merryn nodded. "I will," she promised. "And if it makes you feel any better, after this mission I'll head back to Ivernia and see a diaphrenologist; if he advises that I travel with an Ivernian physician in the future, I will."

Bashir smiled. "That does ease my mind. But even at maximum warp, it's what; a month's journey from Hameron back to Ivernia?"

"That depends on what planet's timeframe you're using, Doctor," Merryn said, adopting her scholarly tone as it struck her for the first time since he had treated her how young this doctor was.

"Six hundred ninety-two standard hours, then… give or take a few minutes," Bashir said, flashing her a quick, almost teasing grin. "Regardless, the point is that the travel time alone is a little long for you to go without a follow-up evaluation. Deep Space Nine will be a bit out of the way on your trip back, but I still think I'd prefer you stop in and let me check you rather than waiting until you get back."

Merryn's eyebrows rose. "Really, Doctor, I'm surprised you haven't just invited yourself along!"

"Couldn't get Sisko to release me," Bashir said with another grin that made it impossible for Merryn to tell if he was teasing or not. "Anyway, I'm just being overly cautious; I'm sure you'll be fine."

 **oOo**

"The ambassador seemed pleased with the repairs you did on her gown," Bashir commented, sliding into the booth across from Garak for their weekly meal together at Quark's.

Garak scowled at his friend in mock irritation. "Those repairs wouldn't have been necessary if you could manage to remember that the proper way to remove a garment is to undo the fastenings, not perform surgery on it."

Bashir chuckled; it was the second time in a month Garak had repaired a garment he had been forced to cut off a patient. "A proper procedure for everything, hm?" he mused. "I'll try to keep it in mind."

The End

 **A/N: The actual medical term for hiccups is either synchronous dia phrag ma tic flutter or** **singultus (at least, according to the information I found on the internet), but I changed it a little because I wanted Bashir to be making the point that it's** _ **different**_ **, not just using the technical term to make it sound more serious. Barbie.**

 _I proofread all my stories at least once before posting, but if you see any mistakes I might have missed, please let me know!_

 _Please note that I have internet access only once a week, and may not have time to respond to all reviews/messages. If you have questions regarding my Deep Space Nine alternate history, check my profile first to see if they're answered there. Thanks for your understanding! Barbie_


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